It is often said that we take our health for granted until something happens to it. I think this is never more the case than with mental health. We operate on the premise that we can tell the difference between what is real and what is the product of a mind diseased. If we can’t, then the very ground of our existence opens up beneath us.
As I say that, I am conscious of the solipsism at the heart of Descartes’ Cogito, ergo sum. If I think, therefore I am, what am I if what I think is not real? Thinking must be in relation to something outside me, connecting with what is, rather than my illusion of what is. The late, great Professor Hawking spoke airily of knowing the mind of God, but how could this be, when the human mind cannot know fully another human mind, and sometimes cannot even know itself? The Psalmist says: “When I see the heavens, the work of your hands, what is man that you are mindful of him?” This is the ground of human existence, that God is mindful of me; I am because I am thought of by He who Is.
I have had experience over the past few years of supporting people whose mental health has become precarious. It has given me great respect for those who work in mental health services, but also a sense of the limits of such care. It seems to me, as a lay observer, that the acute patient can easily become defined by a diagnosis in a narrow, unhelpful way. It becomes the lens through which everything they do and say is viewed.
I was therefore interested in a recent study from the University of Liverpool entitled “Heterogeneity in psychiatric diagnostic classification”. It argued that mental health diagnoses are “scientifically meaningless”. The study analysed sections of the Diagnostic and Statistical Manual of Mental Disorders, or DSM, the standard reference for mental health professionals and anyone assessing mental capacity, for example, Catholic marriage tribunals. The study looked at schizophrenia, bipolar disorder, depressive disorders, anxiety disorders and trauma-related disorders. The research concluded that the same symptoms overlap for multiple different diagnoses and that the decision as to which diagnosis emerges is arrived at by clinicians who do not use standardised rules to make the decision. The study concludes that almost all diagnoses mask the role of trauma and adverse events. This is significant for my own ministry with abuse survivors through the Grief to Grace programme. It confirms my impression that to some extent persons are made to fit diagnoses.
Dr Kate Allsopp, who lead the research, concludes: “Although diagnostic labels create the illusion of an explanation, they are scientifically meaningless and can create stigma and prejudice. I hope these findings will encourage anyone assessing mental health to consider other explanations of mental distress, such as trauma and all adverse life experiences.”
To see the person, not the diagnosis; to listen for a truth hidden by stories which flinch from reality, to be attuned to body and spirit as well as psyche, and care for these; all this means that the best mental healthcare truly is a mission of accompaniment.
It requires belief in the person’s inalienable, transcendent dignity, which is just another way of saying that we should try to think of them as God does.
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